Trigeminal neuralgia (TN) is a neurological disorder marked by severe, stabbing pain along the trigeminal nerve, typically affecting one side of the face. Microvascular decompression (MVD) is the leading surgical treatment when medications fail, offering lasting relief.
A new study conducted at IRCCS Humanitas Research Hospital in Milan, Italy, demonstrated how the RoboticScope enhanced the MVD procedure. Surgeons achieved remarkable results, including a 47% reduction in operating time, improved ergonomic conditions for the surgical team, and seamless integration of endoscopic imaging. These advancements highlight the RoboticScope's potential to streamline workflows and elevate precision in neurosurgery.
The study was led by the distinguished team around Dr. Zefferino Rossini, from the Neurosurgery Department at IRCCS Humanitas Research Hospital. Their expertise and collaboration highlight the global potential of integrating robotic systems into routine neurosurgical practices.
For years, MVD surgery has relied on operating microscopes (OMs), which present challenges such as ergonomic strain on the surgeon and limited visualization in deeper surgical fields. The integration of endoscopes has helped augment visualization in some cases, but these systems either assist the OM or replace it entirely, without offering a seamless combination of both perspectives.
The RoboticScope addresses these limitations by combining high-resolution 3D visualization with robotic precision, and improved ergonomics. In the study, the RoboticScope's VideoIn feature was used to display the endoscopic views directly into the head-mounted display (HMD), enabling surgeons to view both the microsurgical field and endoscopic images simultaneously or toggle between them.
Between September 2023 and March 2024, nine patients with trigeminal neuralgia underwent microvascular decompression (MVD) using the RoboticScope. The surgeries followed the classic mini-retrosigmoid approach, a well-established method for accessing the trigeminal nerve. Comprehensive data collection included patient demographics, surgical times, ergonomic assessments, and clinical outcomes. Pain levels were carefully measured both before and one month after surgery to determine the treatment's effectiveness.
The study revealed several notable advantages of using the RoboticScope in MVD procedures.
Significant Reduction in Operating Time: Surgeries performed with the RoboticScope were completed in nearly half the time compared to those using traditional operating microscopes (median 18 minutes vs. 34 minutes).
Enhanced Ergonomics for Surgeons: Surgeons reported improved comfort and reduced fatigue due to better posture and hands-free control of the robotic system.
Consistently Positive Outcomes: All surgeries were performed successfully without complications. Patients experienced significant reductions in pain levels, demonstrating the procedure’s effectiveness.
These results underscore the RoboticScope’s ability to streamline the surgical process, significantly reducing operating times and improving surgeon efficiency. With its seamless integration of advanced visualization and ergonomic benefits, the RoboticScope is a key innovation that enhances both surgical precision and overall workflow in MVD procedures.
Get the paper here.
Rossini, Z., Tropeano, M. P., Franzini, A., Bresciani, E., Doneddu, P. E., Pensato, U., & Pessina, F. (2024). Microvascular decompression in trigeminal neuralgia using a robot-assisted exoscope and head-mounted display. Neurosurgical Focus, 57(6), E9. https://doi.org/10.3171/2024.9.FOCUS24373
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